title: Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TC) is increasingly recognised in patients presenting with features of acute coronary syndrome. We present a single centre experience of TC with medium term follow up.
  
  
  METHODS
  Fifty-two consecutive patients presenting with a diagnosis of TC were included. The clinical presentation, complications, baseline and follow-up echocardiograms and cardiac magnetic resonance imaging were analysed.
  
  
  RESULTS
  Fifty-one patients were female. A stressful event preceded presentation in 37 (71%) patients. Chest pain was the most common symptom (83%). Two patients presented with an out-of-hospital cardiac arrest. ST segment elevation (40%) and global T wave inversion (44%) were the most frequent electrocardiogram changes. Left ventricular assessment demonstrated typical apical ballooning in 41 patients and 11 patients demonstrated the mid-wall variant. In-hospital complications occurred in 11 patients (21%) and included acute pulmonary oedema (n = 2), cardiogenic shock (n = 5); two of whom had a significant left ventricular outflow gradient, atrial fibrillation (n = 1), left ventricular thrombus (n = 2) and a cerebrovascular event (n = 2). Left ventricular function at presentation and follow up was compared in 40 patients. The mean ejection fraction in this group at presentation was 47% (20-70%) compared with that at follow up of 63% (44-76%). There were no significant complications or recurrences at follow up.
  
  
  CONCLUSIONS
  While TC is a reversible condition with low rates of complications and recurrence at follow up it is, as demonstrated in our cohort, associated with significant in-hospital morbidity in a proportion of patients.
authors.affiliation: Cardiology Program, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Samardhi
authors.forename: O C
authors.initials: OC
authors.lastname: Raffel
authors.forename: M
authors.initials: M
authors.lastname: Savage
authors.forename: T
authors.initials: T
authors.lastname: Sirisena
authors.forename: N
authors.initials: N
authors.lastname: Bett
authors.forename: M
authors.initials: M
authors.lastname: Pincus
authors.forename: A
authors.initials: A
authors.lastname: Small
authors.forename: D L
authors.initials: DL
authors.lastname: Walters
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D006328:Cardiac Catheterization; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002637:Chest Pain / Q000209:etiology*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000453:epidemiology / Q000209:etiology; D011793:Queensland / Q000453:epidemiology; D012770:Shock, Cardiogenic / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D013315:Stress, Psychological / Q000150:complications; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology
chemical_list: D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors